Training is comparable for physicians in other developed countries where the cost of medical care is half or less what it is in the U.S. with better outcomes. With the exception of higher compensation of medical school professors when compared with non-medical school professors' compensation, the training costs in other highly technical fields such as molecular biology, particle physics, chemistry , etc. , are also very high; yet the compensation, which is also high, in these other fields tends to be far lower than in medicine.
In my opinion this is part and parcel of the regulatory capture evident in the entire U.S. Healthcare Complex which operates in a hyper-regulated environment. What we think of as a "free market" in capitalist economies is a market in which both the buyer and seller are free to "walk". We are now very far from a free market in U.S. medicine. Entrenched interests continue to hold us captive to an untenable situation. We continue to behave as though we expect a free market to spontaneously come to our rescue and bring prices under control... I view U.S. medicine as a Cartel. Obamacare left the Cartel largely intact. That's not going to solve the problem. Fundamentally I believe the very high costs of U.S. Medicine is the natural result of our failing to recognize that medicine is one area where it is nearly impossible for a free market, where prices are elastic to demand, to work well. We must wake up to this fundamental fact. This is undoubtedly why most other industrialized nations have adopted a form of single payer healthcare that cuts out middle men and dictates prices. A capitalist approach to healthcare delivery will not work! We don't need a entirely socialist system, such as the VA, where providers are government employees, but we do need the government as a single payer! Looking back to the days prior to both medicare and widespread medical insurance, when most physicians were in private practice and many were making house calls, physicians adjusted their fees according to a patients ability to pay. Just as today, in that prior era, a person needing urgent medical care was not "free to walk"; thus a fundamental requirement of a free market could not be met then, as now. Then, however, physicians had a choice of reducing their fees or refusing to treat and not being paid at all. The ones true to their Hippocratic Oath chose to treat an indigent patient anyway, and they made, in those days, a fine living. But they made comparably less than physicians today. Obviously, if cost is to be reduced to that comparable to what it is in other countries, in other words to a point that medical costs grow no faster than the economy, then someone is going to make less money then they do now! It won't be possible to wring enough cost reductions out of efficiencies alone. We are forced to meet the entrenched interests head on. We do that at the ballot box.!
I haven't. I will. I did. Very interesting. Particularly enlightening was this in depth article in VOX an excerpt from the Vox article: [ https://www.vox.com/policy-and-politics/2017/4/25/15356118/singapore-health-care-system-explained ] Why are conservatives so taken with Singapore? The American Enterprise Institute’s glowing write-up explains it well: "What’s the reason for Singapore’s success? It’s not government spending. The state, using taxes, funds only about one-fourth of Singapore’s total health costs. Individuals and their employers pay for the rest. In fact, the latest figures show that Singapore’s government spends only $381 (all dollars in this article are U.S.) per capita on health—or one-seventh what the U.S. government spends. Singapore’s system requires individuals to take responsibility for their own health, and for much of their own spending on medical care." Here’s what Singapore’s conservative admirers get right: Singapore really is the only truly universal health insurance system in the world based on the idea that patients, not insurers, should bear the costs of routine care. But Singapore isn’t a free market utopia. Quite the opposite, really. It’s a largely state-run health care system where the government designed the insurance products with a healthy appreciation for free market principles — the kind of policy Milton Friedman might have crafted if he’d been a socialist. Unlike in America, where the government’s main role is in managing insurance programs, Singapore’s government controls and pays for much of the medical system itself — hospitals are overwhelmingly public, a large portion of doctors work directly for the state, patients can only use their Medisave accounts to purchase preapproved drugs, and the government subsidizes many medical bills directly. What Singapore shows is that unusual fusions of conservative and liberal ideas in health care really are possible. Singapore is a place where the government acts to keep costs low and then uses those low costs to make a market-driven insurance system possible. One thing you quickly realize when studying their system is it would be a disaster if you tried to impose it in a country with America’s out-of-control medical prices. That speaks to the more depressing lesson of Singapore. As soon as you begin seriously comparing where they are, and how their system works, to where the US is, and how our system works, it becomes painfully clear how far America is from having the institutions or preconditions for truly radical health care reform. ...
Perhaps some locality can start something similar to see if it can be done here? I am thinking of state like Massachusetts, which already have a so called universal system?
My wife was accepted to Med school roughly 25 years ago. She decided against as she felt she could do similar work getting her Masters in essentially the same specialty she was looking to go into for a MD. Well, she works about the same amount of hours as a MD, but is making about 1/3 of what she would be at as a MD, yet putting in the same amount of hours. On the other hand she was out of school at least 5 and possibly 8 years earlier for her desired specialty, and no debt. But back to topic, I get MD's make a load of cash in general, but I really don't believe they are the source of the massive cost hikes year after year. Government bureaucracy(incompetence) and insurance companies mindless layers they add to the system for their profit, not the benefit of the insured is the problem.
You're doing fine it would seem, however your post is a rather extreme overstatement if you intended to suggest that it applies to everyone. There are millions in this country that only have access to ultra expensive, to everyone else, "treat and street" medical care via emergency rooms. They live in Red States with governors who have chosen, for political reasons, to let their State's citizens subsidize medicaid in Blue States while voluntarily receiving no additional federal medicaid benefits for their own States.